401k Plan data: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN plan

OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 401k Plan overview

Plan Name	OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN
Plan identification number	001

OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN Benefits

401k Plan Type	Defined Contribution Pension
Plan Features/Benefits	Profit-sharing Plan not intended to be qualified - A plan not intended to be qualified under Code sections 401, 403, or 408.

401k Sponsoring company profile

OCCUPATIONAL MEDICAL SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: OCCUPATIONAL MEDICAL SERVICES, INC.

Employer identification number (EIN): 660450878

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2014-01-01 CARLOS CANALES CARLOS CANALES 2015-10-09
001 2013-01-01 CARLOS CANALES CARLOS CANALES 2014-10-10
001 2012-01-01 CARLOS CANALES
001 2011-01-01 CARLOS CANALES CARLOS CANALES 2012-10-15
001 2010-01-01 CARLOS CANALES CARLOS CANALES 2011-10-13
001 2009-01-01 CARLOS CANALES CARLOS CANALES 2010-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2014-01-01	CARLOS CANALES	CARLOS CANALES	2015-10-09
001	2013-01-01	CARLOS CANALES	CARLOS CANALES	2014-10-10
001	2012-01-01	CARLOS CANALES
001	2011-01-01	CARLOS CANALES	CARLOS CANALES	2012-10-15
001	2010-01-01	CARLOS CANALES	CARLOS CANALES	2011-10-13
001	2009-01-01	CARLOS CANALES	CARLOS CANALES	2010-10-14

Plan Statistics for OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN

401k plan membership statisitcs for OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN

Measure Date Value
2014: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 0
Number of participants with account balances 2014-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 2
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 2
Number of participants with account balances 2013-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 2
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 2
Number of participants with account balances 2012-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 2
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 2
Number of participants with account balances 2011-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1
Number of retired or separated participants receiving benefits 2010-01-01 1
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 2
Number of participants with account balances 2010-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 2
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 2
Number of participants with account balances 2009-01-01 2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2014: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	0
Number of participants with account balances	2014-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	2
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	2
Number of participants with account balances	2013-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	2
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	2
Number of participants with account balances	2012-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	2
Number of participants with account balances	2011-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1
Number of retired or separated participants receiving benefits	2010-01-01	1
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	2
Number of participants with account balances	2010-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	2
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	2
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	2
Number of participants with account balances	2009-01-01	2
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN

Measure	Date	Value
2014 : OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$0
Expenses. Total of all expenses incurred	2014-12-31	$83,549
Benefits paid (including direct rollovers)	2014-12-31	$83,549
Total plan assets at end of year	2014-12-31	$0
Total plan assets at beginning of year	2014-12-31	$83,549
Value of fidelity bond covering the plan	2014-12-31	$0
Assets. Value of tangible personal property	2014-12-31	$0
Total contributions received or receivable from participants	2014-12-31	$0
Assets. Value of loans (other than to participants)	2014-12-31	$0
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$0
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$-83,549
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$83,549
Assets. Value of participant loans	2014-12-31	$0
Value of loans by the plan or fixed income obligations due to the plan which were in default or classified as uncollectible at the close of the plan year	2014-12-31	$0
Value of leases to which the plan was a party in default or classified as uncollectible during the plan year	2014-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$0
Assets. Value of real-estate (other than employer real property)	2014-12-31	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2014-12-31	$0
Assets. Value of employer securities	2014-12-31	$0
Assets. Value of employer real property	2014-12-31	$0
Total contributions received or receivable from employer(s)	2014-12-31	$0
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0
2013 : OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$12,843
Expenses. Total of all expenses incurred	2013-12-31	$8,400
Benefits paid (including direct rollovers)	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$83,549
Total plan assets at beginning of year	2013-12-31	$79,106
Value of fidelity bond covering the plan	2013-12-31	$0
Assets. Value of tangible personal property	2013-12-31	$0
Total contributions received or receivable from participants	2013-12-31	$0
Assets. Value of loans (other than to participants)	2013-12-31	$0
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$4,443
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$4,443
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$83,549
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$79,106
Assets. Value of participant loans	2013-12-31	$0
Value of loans by the plan or fixed income obligations due to the plan which were in default or classified as uncollectible at the close of the plan year	2013-12-31	$0
Value of leases to which the plan was a party in default or classified as uncollectible during the plan year	2013-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$0
Assets. Value of real-estate (other than employer real property)	2013-12-31	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2013-12-31	$0
Assets. Value of employer securities	2013-12-31	$0
Assets. Value of employer real property	2013-12-31	$0
Total contributions received or receivable from employer(s)	2013-12-31	$8,400
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$8,400
2012 : OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$16,932
Expenses. Total of all expenses incurred	2012-12-31	$8,400
Benefits paid (including direct rollovers)	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$79,106
Total plan assets at beginning of year	2012-12-31	$70,574
Value of fidelity bond covering the plan	2012-12-31	$0
Assets. Value of tangible personal property	2012-12-31	$0
Total contributions received or receivable from participants	2012-12-31	$0
Assets. Value of loans (other than to participants)	2012-12-31	$0
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$4,532
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$8,532
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$79,106
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$70,574
Assets. Value of participant loans	2012-12-31	$0
Value of loans by the plan or fixed income obligations due to the plan which were in default or classified as uncollectible at the close of the plan year	2012-12-31	$0
Value of leases to which the plan was a party in default or classified as uncollectible during the plan year	2012-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$0
Assets. Value of real-estate (other than employer real property)	2012-12-31	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2012-12-31	$0
Assets. Value of employer securities	2012-12-31	$0
Assets. Value of employer real property	2012-12-31	$0
Total contributions received or receivable from employer(s)	2012-12-31	$12,400
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$8,400
2011 : OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$20,791
Expenses. Total of all expenses incurred	2011-12-31	$8,957
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$70,574
Total plan assets at beginning of year	2011-12-31	$58,740
Value of fidelity bond covering the plan	2011-12-31	$0
Assets. Value of tangible personal property	2011-12-31	$0
Total contributions received or receivable from participants	2011-12-31	$0
Assets. Value of loans (other than to participants)	2011-12-31	$0
Expenses. Other expenses not covered elsewhere	2011-12-31	$8,957
Contributions received from other sources (not participants or employers)	2011-12-31	$12,449
Other income received	2011-12-31	$-615
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$11,834
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$70,574
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$58,740
Assets. Value of participant loans	2011-12-31	$0
Value of loans by the plan or fixed income obligations due to the plan which were in default or classified as uncollectible at the close of the plan year	2011-12-31	$0
Value of leases to which the plan was a party in default or classified as uncollectible during the plan year	2011-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$0
Assets. Value of real-estate (other than employer real property)	2011-12-31	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2011-12-31	$0
Assets. Value of employer securities	2011-12-31	$0
Assets. Value of employer real property	2011-12-31	$0
Total contributions received or receivable from employer(s)	2011-12-31	$8,957
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$0
2010 : OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$12,420
Expenses. Total of all expenses incurred	2010-12-31	$8,400
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$58,740
Total plan assets at beginning of year	2010-12-31	$54,720
Value of fidelity bond covering the plan	2010-12-31	$0
Assets. Value of tangible personal property	2010-12-31	$0
Total contributions received or receivable from participants	2010-12-31	$0
Assets. Value of loans (other than to participants)	2010-12-31	$0
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$4,020
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$4,020
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$58,740
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$54,720
Assets. Value of participant loans	2010-12-31	$0
Value of loans by the plan or fixed income obligations due to the plan which were in default or classified as uncollectible at the close of the plan year	2010-12-31	$0
Value of leases to which the plan was a party in default or classified as uncollectible during the plan year	2010-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$0
Assets. Value of real-estate (other than employer real property)	2010-12-31	$0
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2010-12-31	$0
Assets. Value of employer securities	2010-12-31	$0
Assets. Value of employer real property	2010-12-31	$0
Total contributions received or receivable from employer(s)	2010-12-31	$8,400
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$8,400

Form 5500 Responses for OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN

2014: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	Yes
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Section 412(e)(3) insurance Contracts	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Section 412(e)(3) insurance Contracts	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: OCCUPATIONAL MEDICAL SERICES, INC. PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

CONTRACT NUMBER

Policy instance

Insurance contract or identification number	CONTRACT NUMBER
Number of Individuals Covered	0
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	LUIS R. QUINONES ESCOBAR

ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

CONTRACT NUMBER

Policy instance

Insurance contract or identification number	CONTRACT NUMBER
Number of Individuals Covered	0
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	LUIS R. QUINONES ESCOBAR

ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

CONTRACT NUMBER

Policy instance

Insurance contract or identification number	CONTRACT NUMBER
Number of Individuals Covered	0
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	LUIS R. QUINONES ESCOBAR

ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

CONTRACT NUMBER

Policy instance

Insurance contract or identification number	CONTRACT NUMBER
Number of Individuals Covered	0
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ING LIFE INSRUANCE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

CONTRACT NUMBER

Policy instance

Insurance contract or identification number	CONTRACT NUMBER
Number of Individuals Covered	0
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	Yes
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	LUIS R. QUINONES ESCOBAR

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Company Name:	OCCUPATIONAL MEDICAL SERVICES, INC.
Employer identification number (EIN):	660450878
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)